How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,148.15 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,148.15 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $1,148.15 Typical High $4,677.35 | Professional | None | $218.78 | $1,148.15 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $6,918.31 | Facility | None | $1,348.96 | $2,238.72 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $741.31 | Professional | None | $257.04 | $346.74 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $1,148.15 Typical High $1,659.59 | Facility | None | $389.05 | $1,148.15 | $1,659.59 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $1,023.29 Typical High $1,445.44 | Professional | None | $223.87 | $1,023.29 | $1,445.44 |
Premera BCBS Setting Facility Modifier None Typical Low $676.08 Median $1,905.46 Typical High $2,511.89 | Facility | None | $676.08 | $1,905.46 | $2,511.89 |
Premera BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $6,918.31 | Facility | None | $1,318.26 | $1,905.46 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $223.87 Median $501.19 Typical High $741.31 | Professional | None | $223.87 | $501.19 | $741.31 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $229.09 Median $676.08 Typical High $1,230.27 | Professional | None | $229.09 | $676.08 | $1,230.27 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $109.65 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $44.67 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $851.14 Typical High $870.96 | Professional | 54 · Surgery only | $165.96 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $33.11 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $21.88 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $794.33 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $154.88 | $794.33 | $812.83 |
Where Alaska sits
The same service costs 5.4 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Alaska· 1st of 51
$1,023
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.